Key result
High interdialytic weight gain in hemodialysis patients was associated with significantly greater increases in left ventricular mass index and decreases in ejection fraction compared to low IDWG.
Why the study?
Interdialytic weight gain and volume overload are important risk factors for cardiovascular mortality in chronic hemodialysis patients, but their relation to outcomes required further assessment.
Does high interdialytic weight gain worsen echocardiographic parameters and clinical outcomes in ESRD patients on maintenance hemodialysis?
Cohort (n=100)
No
Does high interdialytic weight gain worsen echocardiographic parameters and clinical outcomes in ESRD patients on maintenance hemodialysis?
High interdialytic weight gain in hemodialysis patients is associated with adverse cardiac remodeling, including increased left ventricular mass index and decreased ejection fraction.
May support closer IDWG monitoring in hemodialysis; extends observational links to remodeling but leaves causality open.
Introduction The most common cause of mortality among chronic hemodialysis (HD) patients is cardiovascular disease. Hypervolemia is an important risk factor for hypertension and cardiovascular mortality in HD patients that include chronic volume overload and interdialytic weight gain (IDWG).IDWG affects cardiovascular morbidity and mortality Daily fluctuations in extracellular fluid volume might promote cardiac remodeling resulting in left ventricular hypertrophy (LVH) and cardiac fibrosis. Aim of the study to assess interdialytic weight gain and (its relation to morbidity and mortality) among patients on maintenance hemodialysis. Patient and methods 100 ESRD patients on regular hemodialysis included in study in Ain Shams University hospitals in march 2016 and followed up after one year in march 2017. Type of study cohort study Patients were divided into two groups according to interdialytic weight gain (IDWG): Group I (high IDWG) 50 patients with Absolute weight gain 4kg or more. Or relative IDWG more than 3.5% of total body weight. Group II (low IDWG) 50 patients with absolute weight gain less than 3kg Or relative IDWG less than 3.5% of total body weight. Echocardiography (TTE) for all patients at the start of the study and followed up after one year for detecting outcomes included all-cause mortality, cardiovascular mortality, hospitalization for heart failure/volume overload, hospitalization for myocardial infarction, stroke. Results we found that patient with high (IDWG) group II has significantly higher increase in left ventricular mass index (LVMI),inferior vena cava (IVC) diameter and significantly higher decrease in ejection fraction more than low IDWG group I. Conclusions Patients with high IDWG group II at higher risk of increase LVMI, decrease ejection fraction, increase in interventricular septum (IVS), increase in inferior vena cava diameter more than patients of low IDWG group I and has more cardiovascular morbidity and mortality.
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Ibrahim et al. (2020) conducted a cohort in End-stage renal disease on maintenance hemodialysis (n=100). High interdialytic weight gain (≥4kg or >3.5% of body weight) vs. Low interdialytic weight gain (<3kg or <3.5% of body weight) was evaluated on Echocardiographic changes (LVMI, IVC diameter, ejection fraction) and cardiovascular morbidity/mortality. High interdialytic weight gain in hemodialysis patients was associated with significantly greater increases in left ventricular mass index and decreases in ejection fraction compared to low IDWG.
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